A case‐control study of diet and gastric cancer in Northern Italy

Abstract

Dietary factors in the aetiology of stomach cancer were investigated using data from a case-control study conducted in Northern Italy on 206 histologically confirmed carcinomas and 474 control subjects in hospital for acute, non-digestive conditions, unrelated to any of the potential risk factors for gastric cancer. Dietary histories concerned the frequency of consumption per week of 29 selected food items (including the major sources of starches, proteins, fats, fibres, vitamins A and C, nitrates and nitrites in the Italian diet) and subjective scores for condiments and salt intake. Pasta and rice (the major sources of starch), polenta (a porridge made of maize) and ham were positively related with gastric cancer risk, whereas green vegetables and fresh fruit as a whole (and specifically citrus fruit) and selected fibre-rich aliments (such as whole-grain bread or pasta) showed protective effects on gastric cancer risk. Allowance for major identified potential distorting factors (chiefly indicators of socio-economic status) reduced the positive association with pasta or rice consumption, but did not appreciably modify any of the other risk estimates. When a single logistic model was fitted including all food items significant in univariate analysis, the 3 items remaining statistically significant were green vegetables (relative risk, RR = 0.27 for upper vs. lower tertile), polenta (RR = 2.32) and ham (RR = 1.60). Indices of beta-carotene and ascorbate intake were negatively and strongly related with gastric cancer risk, but the association with these micronutrients was no longer evident after simultaneous allowance for various food items. An approximately 7-fold difference in risk was found between extreme quintiles of a scale measuring major positive and negative associations.

Recent patterns in gastric cancer: A global overview

“…Primary prevention of stomach cancer by dietary means is feasible by encouraging high-risk populations to decrease consumption of cured meats and salt preserved foods, and increase the consumption of vegetables and fruit. [42][43][44][45][46][47] Prevention may also be feasible through eradication of H. pylori infection, particularly in childhood and adolescence.…”

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“…Overall, in the majority of case-control studies, positive associations were observed for (total) salt or sodium intake [2,3,33,34], consumption of salted fish, salted meat, pickles and soup [5,7,16,[34][35][36][37][38][39][40], adding salt to food at dinner [5,9,41], preference of salty foods [4,5,11,40,42]. The relative risks reported ranged from 1.5 to 6.7 for various measures of salt intake [14].…”

“…Most case-control studies have reported positive associations between meat products and stomach cancer risk [5, 7, 10, 15-17, 42, 47, 54, 55], but not all [9,13,33,56]. A cohort study among Hawaiians of Japanese descent reported a non-significant positive association between stomach cancer risk and the consumption of processed meats [48,49].…”

Diet and ovarian cancer risk: A case-control study in Italy

“…32,33 This relation should, however, be considered with caution, because the estimates for bread, pasta and rice, and sugar were only marginally significant, and the association with soups may well constitute an unspecific indicator of a poor diet in this population. 34 This study has the strengths and some of the limitations of the hospital-based case-control studies. 26 In particular, the enrollment of cases and controls in major teaching and general hospital of the areas under study, and their almost complete participation indicate that selection bias is unlikely to be relevant.…”